Options for Single Women
Fertility Treatments Using Donor Sperm
CHR provides a variety of fertility treatment options to single women who want to have children. Single women typically need a sperm donor to conceive, but other than the need for a sperm donor, fertility treatment options for single women are similar to those available to couples. The deciding factor is the type and severity of infertility issues that each patient has (if any).
For example, if a single female patient has open, normally functioning tubes, normal ovarian reserve and normal uterus, all she needs may be a cycle of intrauterine insemination (IUI) using donated sperm. In contrast, if the patient has diminished ovarian reserve (DOR), or her tubes are blocked, she may need in vitro fertilization (IVF) with donor sperm. If the patient's ovarian reserve is too low, she may need both egg and sperm donation to conceive. Our physicians will determine each patient's needs through consultations and diagnostic testing in order to suggest the best course of action for each patient.
While CHR is not a sperm bank, and does not provide sperm donors to our patients, we work with a number of reputable sperm banks. Our clinical coordinators can put patients in touch with FDA-approved sperm banks from which they can obtain donor sperm. With our egg donation program that has a large and diverse pool of egg donors, CHR can help single women who need egg donors find a good match quickly.
While going through IUI or IVF with donor sperm is common among single women who want to start a family, there is another option for single women: embryo adoption. In IVF cycles, sometimes there are "extra embryos" left over after a few of the best-quality embryos are used for fresh embryo transfer. These extra embryos can be used for later frozen embryo transfers if patients want to have more children in the future. However, patients may feel that their family is complete after a successful delivery or two even though they still have extra embryos frozen from their original IVF cycle. In these cases, patients have an option of anonymously donating the extra embryos to other infertility patients.
CHR is one of the few IVF centers that maintain its own embryo adoption/donation program, and usually have a few sets of frozen embryos available for adoption. Over the years, we have helped single women (as well as couples) build their families using our embryo adoption program.
Fertility Preservation for Social Reasons
For single women who are not ready to start a family but are worried that their fertile years may be exhausted before they find the right partners, fertility preservation may be an option. There are several methods of fertility preservation, some more experimental than others:
- Embryo freezing: Embryo freezing is the most well-understood, well-established method of fertility preservation. The patient undergoes a normal IVF cycle, but instead of having embryo(s) transferred at the end of the treatment cycle, chooses to have all the embryos frozen for future use. This option requires that the patient commit to a sperm donor, and may not be a viable option for everyone. However, pregnancy rates after thawing are the highest with embryo freezing, and for women who think of fertility preservation as a backup option, embryo freezing can be a good option.
- Egg freezing: Despite recent excitement surrounding egg freezing in the media, egg freezing is still a largely experimental procedure, especially for the purpose of delaying childbearing (rather than in emergency medical situations like impending chemotherapy for cancer, for example). In an egg freezing cycle, the patient also undergoes a process similar to a normal IVF cycle. After the eggs are retrieved, instead of being fertilized with sperm, they are frozen for future use. There is not enough data on how many eggs would be needed to have a reasonable chance of pregnancy in the future, but egg freezing is more effective when it is performed at a younger age.
- Ovarian tissue freezing: The outer layer of ovaries (called ovarian cortex) contain a large number of dormant, premature cells that will later grow into eggs. In ovarian tissue freezing, strips of the ovarian cortex are harvested and frozen. When the patient is ready to have children, the ovarian strips are thawed and placed back into the body to produce mature eggs. This is an experimental procedure with only 30 or so live births so far in the world, and only used in medical emergencies. It may be years before this procedure becomes available for single women looking to preserve their fertility.
Options for Single Men
Single men who want to have children face a more complicated challenge than single women: they need egg donation and a gestational carrier (surrogate) to carry the pregnancy to term. Single men can take advantage of our large and diverse pool of egg donors, and be quickly matched with an egg donor who closely matches each patient's criteria. Briefly, in an egg donation cycle, the egg donor undergoes ovarian stimulation and has multiple eggs retrieved when they are mature after 2-3 weeks. The eggs are fertilized with the patient's sperm in the laboratory, and in this case transferred to the uterus of the gestational carrier.
While CHR does not directly provide gestational carrier services, we have worked with a number of reputable agencies, and can put our patients in touch with them. Because surrogacy is a complicated legal process, CHR always strongly urge patients to obtain independent legal counsel.
In some cases, there may be male infertility factors involved, like low sperm count, poor sperm morphology (shape) and poor sperm motility (movement). All these issues compromise the sperm's ability to fertilize the eggs, and are typically found through semen analysis. Many of the issues related to the sperm's shape and mobility can be addressed by using a laboratory technique called intracytoplasmic sperm injection (ICSI), which directly injects the best sperm from a sample into the egg to facilitate fertilization. With ICSI, most men with sperm issues can become biological fathers. Even when there is no sperm found in the ejaculate (a condition called azoospermia), there are microsurgical techniques to extract sperm directly from the testes, which can be used to fertilize the donor's eggs. Our urology affiliates are experts in these procedures.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.